Adaptation of the Welsh National Exercise Referral Scheme (NERS) to virtual delivery: Evaluation of impact and opportunities

Evaluation in progress. Expected completion date August 2022

Outputs coming soon

What does the research mean for Local Authorities?

The knowledge from this research will provide an understanding of whether and how NERS could be delivered virtually in the future (in addition to core face-to-face delivery) and the implications of this in terms of service user uptake, engagement, outcomes, and programme costs. This will take into consideration the learning gained from delivering the programme virtually in response to the Covid-19 pandemic. More widely, the findings may also be of interest to others responsible for developing or managing health improvement programmes who are considering introducing virtual delivery.

What does the evaluation research mean for the Public?

Adding virtual delivery to NERS could increase programme accessibility and improve health outcomes e.g. there may be groups of people whose circumstances make face-to-face attendance challenging. This research will help to identify who these groups of people are and how they can be best supported to engage in this way. The findings will inform NERS programme managers, and those responsible for other types of health improvement programmes, to deliver public services that are increasingly person-centred and flexible. 

How are the public involved in the evaluation?

The public are involved throughout the project in several different ways. This includes a local service user consultation group who develop research questions important to them, assist with data analysis, provide insight when discussing findings and producing outputs. Additionally, throughout all PHIRST Connect projects the Public Involvement in Research group act as a critical friend on key elements of the research process, and in some situations act as co-researchers.   

Lay summary of research

The National Exercise Referral Scheme (NERS) is a Welsh Government programme that operates across the whole of Wales. It aims to help members of the public to improve their physical and mental health and wellbeing by providing access to personalised and supervised physical activity.

NERS is aimed at people aged 16 years and over, who are not used to taking part in physical activity or who are at risk of, or currently experiencing, a long-term health condition. People are referred onto NERS by a health professional such as a doctor, nurse or physiotherapist, and then take part in a 16-week programme of exercise sessions while being supported by a trained ‘exercise professional’. The sessions are designed to be fun and easy to fit into everyday life.

The Covid-19 pandemic meant that in March 2020 the NERS programme had to change the way it delivered its services. One of the main changes was that it moved from running exercise sessions face-to-face to running them virtually (for example, with people joining in with live sessions from their own homes while watching their instructor on a smartphone, tablet or computer).

The aim of the study is to understand whether this change in the way that NERS has been run has affected:

  • whether people have joined NERS in the first place
  • whether people have taken part in the sessions
  • whether people have stayed involved for the full 16 weeks of the programme
  • people’s physical and mental health and wellbeing

The study aims to answer the following, broad research questions: 

  • How has delivering NERS virtually affected whether people join the project, take part in exercise sessions, and complete all 16 weeks of the programme
  • Are there things that increase or decrease the chances of people joining and taking part in NERS, and what are these for different groups of people?
  • How do the outcomes for service users who experience virtual NERS delivery compare with those for service users who experience it face-to-face? Do some groups of people have better outcomes than others when NERS is delivered virtually or face-to-face?
  • How do the costs of running NERS virtually compare to the costs of running it face-to-face?
  • What might be the best way to deliver NERS in the future and what might be the benefits and downsides of these different options?

The research design includes

1. Asking staff who help deliver NERS to take part in group discussions 

2. One-to-one interviews with NERS service users and people referred on to NERS but who never took it up 

3. Looking at information on health and wellbeing outcomes to see what has changed for those who took part in NERS and if this varies for different groups of  service users (for example, those who experienced NERS virtually compared to those who experienced it face-to-face, and those with different health conditions)  

4. Looking at how much virtual delivery costs compared to face-to-face delivery 

5. Running a workshop to work together with those involved in NERS to explore the best way for NERS to be run in the future

PHIRST Connect

Research team

Dr Katie Newby, Charis Bontoft, Dr Olujoke Fakoya, Imogen Freethy, Dr Neil Howlett, Nigel Lloyd, Nigel Smeeton, Dr Adam P Wagner, Amander Wellings, Professor Wendy Wills,

*All PHIRST Connect members input into every project 

Local Authority/Partner(s)

Welsh Local Government Association and Public Health Wales